20% of people in the UK lack basic digital skills and or do not use digital technology. We know that a lot of these people, such as elderly patients, disabled people, low income earners and non english speaking people could benefit from digital healthcare. How can we provide them with a great experience to overcome digital exclusion?

Timeframe

Jun 21 - Nov 21

Role

Senior product designer

Services

Research
UX Design
Visual Design

Learnings

Collaboration
Empathy
Service design

📱 What is Digital Exclusion?

Digital exclusion has changed over the years, from a simple ‘user / non-user’ to exploring different levels of internet use and skills divisions. Broadly defined, digital exclusion is where a section of the population have continuing unequal access and capacity to use information and communications technologies that are essential to fully participate in society.

Digital inclusion is about working with communities to address issues of opportunity, access, knowledge and skill in relation to using technology, and in particular, the internet.

🚧 Barriers to digital inclusion

Access Not everyone has the ability to conect to the internet and go online
Confidence Some people fear online crime, lack trust or don't know where to start 
Skills Not everyone has the ability to use the internet and online services
Motivation Some peope don't see how using the internet could be helpful to them

8,400,000

Of people in the UK had no access to a digital device in 2020

11,900,000

People lack the basic digital skills to use the internet effectively

4,800,000

People never go online at all

📍Short-term goal

Work with Hounslow surgery to understand user requirements/demand and test features and outcomes which can reduce digital inclusion

🎯Long-term goal

To empower people across the UK to transform their healthcare experience by improving access for everyone to digital platforms and tools.

Working backwards...

At the start of the project, we were told that the business had already spent a considerable amount of money on a 'Pod', with the plan to buy more. The idea being that digitally excluded patients could have Push Doctor consultations in them at physical locations. However, very little thought was put into how these would actually work in the real world, and my brief was pretty much to explore the best possible uses for the Pods. This included everything from location and security of the pods, accessibility and any software/product needs.

Obviously in an ideal world, all of this discovery work would have been done before money was spent on the pod, to ensure it was a feasible idea. Nonetheless I cracked on with the project to see how we could use them. If I could have done things differently, I would have explored and researched a variety of solutions to improve digital inclusion, and prioritised the one which would have the maximum effect for the least effort. Rather than a hit and hope approach which could turn out to be costly.

Insights gathering

At My first port of call was to set up a meeting with the wider team and stakeholders to try and gain more of an insight into the project, set some goals and better define the problem (Which should have been done before). I quickly began to understand that we were being thrown in at the deep end having already ordered these pods without knowing how we'll use them. For instance;

Where will the pods go?
Will people even use them?
How will patients use them?
How will we market them?
and so on..

Empirical research

Next, I wanted to do some research to try and understand the people who would be using these pods and whether or not they would feel comfortable using them.

Visits to Hounslow GP surgery
To see first hand the problems our patients were facing. Also interviewed the care navigators to gain insights from them. 

Patient participation group
Spent time with the patient participation group to gain valuable insights from the patients themselves

Speaking to the digitally excluded
Identified patients who were potentially digitally excluded and spent time with them to understand their needs

Analytical research

NHS Data
Gathered and analysed data from the NHS using their GP patient survey. This has a massive amount of information available, from national level, to CCG and practice results. It allows you to drill down into demographical data and comprehensively analyse patient experiences.

Online research
I spent a large amount of time analysing documents, papers and articles online about digital inclusion. This gave me a really good background of the problem and insights into what other people had done to tackle it.

Hounslow demographics

The Pod would be in Hounslow, as we were partnered with Hounslow doctor’s surgery on this project. With that in mind, I started to look at the demographics of the area to see what type of people would/could be using these pods. Using the gov.uk and NHS data I found quite a lot of interesting insights;

• The population in the borough is ageing
• Hounslow is a diverse borough and becoming more diverse each year
• Hounslow is the 7th worst ranking London borough in terms of low paid residents

All of these points could lead to a lot of people becoming digitally excluded and potential users of the pod. The next step was to try and identify and speak to some of these people to learn more.

Patient journey mapping

Using the research and insights i gathered, I identified that there were two types of patients that we should be prioritising. The Polish speaking patients and the elderly patients who struggled with technology. These were the two most digitally excluded demographics at the surgery.

Based on the findings, I put together a customer journey map for each patient using the pod. This allowed me to put myself in the shoes of these patients, and understand the probelms they may be facing. Sharing these with the wider business also helped gain exposure and increase awareness for these types of patients.

Meet the product

Service prototyping

To gain a better understanding of how people could use the pod, I did some prototyping using a real pod. We had one delivered to the office and using team members, I tried to imagine how the pod would be used in a real life scenario. We prototyped some dummy consultations to see how things went, and gained some valuable insights;

Physical design
The design of the pod wasn’t suitable. There were no locks on the doors and windows were see through, creating privacy issues.

Hygiene
How would we maintain good hygiene in the pod, especially during current COVID times?

Security
How could we stop people from stealing the iPad etc?

Privacy
What if a patient forgets to log out etc before someone else enters?

🙀 Back to the drawing board...

From the research I undertook and the outcomes of the prototyping session, it was becoming increasingly clear to me that the pod wasn't, in its current form, a viable solution. The prototyping session clearly highlighted major problems, all of which would take a lot of time, effort and money to solve. 

I decided to raise my concerns to senior members of the business, and proposed that we re-evaluate the project before spending anymore time on it. I thought it would be better to reframe the problem, as opposed to launching something with many flaws, that may never get used anyway. Luckily after seeing what we had done, everyone was on the same page and agreed it would be best to park the idea for now.

🤔 Re-framing the problem

The original brief was to improve the experiences of digitally excluded people at Hounslow surgery. Going back to the start, rather than focusing on the 'pod', research had shown that Hounslow had a very large population of non English speaking people. They often had trouble consulting with our doctors because of the language barrier, especially when using the app. In fact, many couldn't use the app at all. WIth that in mind, it made sense to focus on this group of patients and try and improve their experience first.

The Solution - Translation

After carrying out extensive research into the initial problem, it was clear that the intended solution wouldn’t work. 

This highlights the importance of doing as much research as possible before jumping into a solution based on assumptions. After speaking to our target users, it was clear that language was the biggest barrier. We decided to re-focus our efforts on the users who needed it most - the polish speaking community in Hounslow.

Initially, we looked into translating the app into Polish, however after discussing with engineering, this was going to take a massive amount of time and effort. We decided that as an MVP, we would use a third party company to provide translation services only in the consultation area. If this went well, we would then look at rolling it out to the wider product.